Background

Motor competence is an important predictor of health behaviours. However, levels of motor competence are low in children and adolescents. Many interventions have improved motor competence, yet intervention effects were highly variable. Potential causes of such variations are not fully understood. Process evaluation can assist with the understanding of why an intervention worked or not, but its application and reporting in motor competence interventions has received little attention.

Objectives

The primary aim of this review was to investigate whether process evaluations have been reported in interventions to improve motor competence and, if reported, which process evaluation measures have been used. A secondary aim was to explore the association of intervention characteristics and process evaluation findings (outcomes of process evaluation measures) with intervention outcomes, in a search for what process evaluation measures may impact on intervention functioning and outcomes.

Methods

The process of conducting and reporting this review adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The review protocol was registered with PROSPERO (CRD42019124412). A systematic search of seven electronic databases (i.e. MEDLINE [via EBSCOhost], Cochrane Central Register of Controlled Trials [CENTRAL], CINAHL, Academic Search Complete, Education Database, SPORTDiscus and Scopus) was conducted with no date restrictions. Eligibility criteria included the following: (1) a study sample of typically developing children and adolescents aged 5–18 years, (2) an intervention aimed to improve motor competence, (3) an intervention included a control group, (4) a report of motor competence outcome at both pre- and post-intervention. Only original articles published in English in peer-reviewed journals were considered. Process evaluation measures and findings were extracted using the UK Medical Research Council’s process evaluation framework in order to provide overarching descriptions on the implementation, mechanism of change and context of interventions. Univariable meta-regressions were performed to ascertain whether selected study-level covariates moderated the improvement in motor competence outcomes in interventions.

Results

The search identified 60 intervention studies. Only 30 studies (50%) reported process evaluation measures. No studies reported (or employed) theoretical frameworks to guide process evaluation. Process evaluation measures relating to implementation were most commonly reported, with the most prevalent aspect being fidelity. This was followed by reporting on measures relating to mechanism of change and context of the intervention. Meta-analysis results suggested intervention duration, dose, inclusion of process evaluation aim, provision of lesson plans, sample size and sex as potential moderators.

Conclusions

Reporting of process evaluation measures may help build our understanding of the optimal characteristics of motor competence interventions. However, process evaluation is under-used and/or under-reported. This review serves as a call for more process evaluations and better reporting in motor competence interventions.

中文翻译：

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这不仅仅是你做什么，而是你做它的方式：对提高粗大运动能力的干预过程评估的系统评价

背景

运动能力是健康行为的重要预测指标。然而，儿童和青少年的运动能力水平较低。许多干预措施提高了运动能力，但干预效果差异很大。这种变化的潜在原因尚不完全清楚。过程评估可以帮助理解为什么干预有效或无效，但它在运动能力干预中的应用和报告很少受到关注。

目标

本综述的主要目的是调查是否已在提高运动能力的干预措施中报告了过程评估，如果报告了，则使用了哪些过程评估措施。次要目的是探索干预特征和过程评估结果（过程评估措施的结果）与干预结果的关联，以寻找哪些过程评估措施可能影响干预功能和结果。

方法

进行和报告本次审查的过程遵循系统审查和元分析 (PRISMA) 指南的首选报告项目。审查方案已在 PROSPERO (CRD42019124412) 注册。对七个电子数据库（即 MEDLINE [通过 EBSCOhost]、Cochrane Central Register of Controlled Trials [CENTRAL]、CINAHL、Academic Search Complete、Education Database、SPORTDiscus 和 Scopus）进行了系统检索，没有日期限制。资格标准包括以下内容：(1) 5-18 岁正常发育的儿童和青少年的研究样本，(2) 旨在提高运动能力的干预措施，(3) 干预措施包括对照组，(4) 报告干预前后的运动能力结果。仅考虑在同行评审期刊上以英文发表的原创文章。使用英国医学研究委员会的过程评估框架提取过程评估措施和结果，以提供关于实施、变化机制和干预背景的总体描述。进行单变量元回归以确定选定的研究水平协变量是否调节干预措施中运动能力结果的改善。

结果

搜索确定了 60 项干预研究。只有 30 项研究 (50%) 报告了过程评估措施。没有研究报告（或采用）指导过程评估的理论框架。最常报告与实施相关的过程评估措施，其中最普遍的方面是保真度。随后报告了与变化机制和干预背景有关的措施。荟萃分析结果表明干预持续时间、剂量、过程评估目标的包含、课程计划的提供、样本量和性别是潜在的调节因素。

结论

报告过程评估措施可能有助于我们了解运动能力干预的最佳特征。然而，过程评估未得到充分利用和/或报告不足。该审查呼吁对运动能力干预进行更多的过程评估和更好的报告。